AB0147 INFLAMMATORY AND NEUTROPHIL ACTIVATION MARKERS IN PATIENTS WITH BEHÇET’S DISEASE
Authors: K. Nurbaeva, T. Lisitsyna, T. Reshetnyak, R. Goloeva, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background Behçet’s disease (BD) is a systemic variable vessel vasculitis with different clinical manifestations. BD does not have specific laboratory findings. Neutrophil hyperactivation is a major pathogenic factor in BD-related inflammation and tissue damage. Neutrophil reactivity (NEUT-RI), neutrophil granularity (NEUT-GI), immature granulocytes (IG), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet-lymphocyte ratio (PLR) are considered as inflammatory markers. Their role in BD remains unclear. Objectives to determine the importance of parameters of neutrophil activation (NEUT-RI, NEUT-GI), immature granulocytes (absolute (IG#), relative (IG%) counts), NLR, MPV, PLR in assessing inflammation in BD. Methods 29 patients with a reliable BD according to ICBD 2014 and 40 age-matched healthy donors (HD) without acute infectious diseases or cancer were included in the study (Table 1). Patients with BD were separated into two groups: 22 with active and 7 with inactive BD. Active BD was defined as involvement of at least two of the following features: oral ulcers, genital ulcers, uveitis, intestinal involvement, skin lesions, neurological involvement, arthritis, and vascular involvement. Current disease activity was evaluated with transformed Behçet’s Disease Current Activity Form (BDCAF). A complete blood count (WBC-white blood cell, NEUT#-an absolute neutrophil count, NEUT-RI, NEUT-GI, IG%, IG#, NLR, thrombocytes, MPV, PLR, ESR-erythrocyte sedimentation rate) was performed with XN-1000 automated hematology analyzer (Sysmex, Japan). Table 1. Comparative characteristics of patients with active/inactive BD and healthy controls. Parameters M±SD, Me [25%; 75%], n (%) Active BD (n=22) Inactive BD (n=7) Healthy donors (n=40) p Gender: male/female, n 16/6 4/3 16 /24 NS Vascular involvement,n 7 3 - NS BDCAF 5 [5; 8] 1 [0; 3] - p&lt;0.001* WBC, 10 9 /l 7.4 [5.9; 8.6] 6.9 [6.5; 8.4] 6.05 [5.2; 6.9] p=0.04* Thrombocytes, 10 9 /l 264.33±56.95 305.11±104.82 257.46±53.18 NS NEUT#, 10 9 /l 3.91 [3.34; 5.03] 3.89 [3.78; 5.5] 3.41 [2.86; 4.13] NS NEUT-RI, FI 45.95 [44.1; 47.1] 46.25 [44.95; 47.75] 43.7 [42.7; 46.2] р=0.049* NEUT-GI, SI 154.84±4.05 157.04±5.55 153.37±4.7 NS NLR 1.64 [1.39; 1.91] 1,9 [1.73; 2.6] 1.83 [1.4; 2.28] NS ESR, mm/ 6.5 [4.5; 17.0] 12.0 [4.0; 15.0] 7.0 [4.0; 11.0] NS IG#,10 9 /l 0.02 [0.01; 0.04] 0.04 [0.01; 0.07] 0.01 [0.01; 0.02] р=0.036* IG% 0.3 [0.2; 0.4] 0.45 [0.25; 0.65] 0.2 [0.2; 0.3] р=0.018* CRP, mg/l 2.5 [1.2; 7.4] 2.45 [1.28; 4.65] - NS MPV, fl 10.4 [9.7; 11.0] 9.85 [9.6; 11.0] 10.5 [10.1; 11.2] NS PLR 116.45 [83.5; 138.6] 151.55 [119.5; 171.1] 137.1 [104.4; 160.1] NS Fibrinogen, g/l 3.48±0.8 2.88±0.4 - NS *a statistically significant test result (p ≤ 0.05); NS-not significant;FI- fluorescence intensity; SI- scatter intensity; fl- femtoliter. Results A WBC count was significantly higher in BD patients compared to controls (Table 1). Patients with active BD had a higher WBC count than inactive. Patients with BD were found to have significantly higher levels of IG#, IG%, and NEUT-RI compared to HD. There was no significant difference between NEUT-GI, NLR, MPV, PLR, and ESR levels in patients with BD and HD. No significant difference in NEUT-RI, NEUT-GI, NLR, IG #, IG%, PLR, or MPV between active and inactive BD was found. These hematological parameters did not correlate with the transformed BDCAF score. IG# levels positively correlated with total leukocyte count (r s =0.656, p&lt;0.001) and the absolute neutrophil count (r s =0.548, p=0.002). There was a tendency to a positive correlation between IG# and NEUT-GI (r s =0.354, p=0.050) and a negative correlation between IG# and PLR (r s =-0.356, p=0.052). Conclusion Patients with BD had significantly higher total WBC counts, immature granulocyte levels, and neutrophil reactivity than controls. Except for the leukocytes, there was no statistically significant difference in the studied parameters between patients with active and inactive BD. The study was performed at V.A. Nasonova Research Institute of Rheumatology within the framework of the fundamental research FURS-2022-003. Disclosure of Interests None declared